Job Appliaction
Job Appliaction
(Last)
(First)
5-9-14
____________________
(Middle)
Date
(City)
(209 ) 947-0873
(Telephone Number)
(State)
(Zip Code)
N/A
N/A
(
)____________________
____________________________
(Alternative Telephone Number)
(Email Address)
N/A
Languages spoken and/or written (other than English):___________________________________
Have you ever been convicted, pleaded guilty or no contest to a misdemeanor or felony?
No
Yes
If yes, explain:________________________________
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
High School
City/State
Course of
study or
major
College/
University
Last year
completed
Did you
graduate?
Diploma
or degree
1 2 3 4
Pending
Diploma
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Avid club, Mojo program, DOS program, Boys and girls club volunteer work
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
N/A
4pm-9pm
4pm-9pm
4pm-9pm
4pm-9pm
4pm-9pm
2pm-6pm
2014
I.H.S.S
Title__________________________Last
Salary: _____________
_________________________________________________
Duties
_________________________________________________
_________________________________________________
To:
4/10
______
4/14
______
Mo / Yr
Mo/Yr
4
4
Total ____Yrs.
________Mo.
14
Hours Per Week:_________
Reason For Leaving:
From:
5/14
______
Mo/ Yr
Mo/Yr
9
1
Total ____Yrs.
________Mo.
Hours Per Week:_________
7
Reason For Leaving:
(209)722-1738
_________________________________________________
Supervisors Name:
Sonia Hughes
_____________________________________________________
_________________________________________________
2014
Title__________________________Last
Salary: _____________
Mojo
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
To:
7/13
______
_________________________________________________
_________________________________________________
Supervisors Name:
Rachelle Abril
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Rachelle Abril
Phone
Occupation_______
1(209)947-8827
Business women
________________________________________________________________________________________________________________________________
2. Javier
Zepeda
(209)720-9091
Handy Man
________________________________________________________________________________________________________________________________
3. Rosalinda
Reyes
(209)917-9517
Daycare
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________